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NPI Code Detail

MEDICARE: CHARLESTON CHIROPRACTIC COMPANY PLLC

MEDICARE: CHARLESTON CHIROPRACTIC COMPANY PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor944WV

General Provider Information

NPI Number : 1194147330
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLESTON CHIROPRACTIC COMPANY PLLC
Provider Business Mailing Address
First Line : 713 BIGLEY AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-3356
Country : US
Telephone Number : 304-344-2225
Fax Number : 304-344-2226
Provider Business Practice Location Address
First Line : 713 BIGLEY AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-3356
Country : US
Telephone Number : 304-344-2225
Fax Number : 304-344-2226
Authorized Official
Title or Position : OWNER/CHIROPRACTOR
Name : DR. JENNIFER BULGER
Credential : DC
Telephone Number : 304-344-2225
Provider Enumeration Date : 01/07/2014
Last Update Date : 01/07/2014

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Directions to “CHARLESTON CHIROPRACTIC COMPANY PLLC ” Practice Location

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